Mediastinal parathyroid cysts revisited

Shields, Thomas W.; Immerman, Steven C.

doi:10.1016/s0003-4975(99)00018-1

Cited by 73 publications

(60 citation statements)

References 30 publications

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“…Rarely there are clinical signs corresponding to a complication: cervical pain [1,3,11,19] and/or thoracic pain [18] or compression symptoms [3,8,11,16,[18][19][20], dyspahgia (one of our observations), dysphonia [5,20] dyspnoea, dry cough or stridor [15,21] deviation and vascular compression [11,18,22]. Systemically the patient will be normal unless the cyst causes significant hyperparathyroidism which itself can be symptomless.…”

Section: Discussionmentioning

confidence: 82%

“…They contain a clear mucous fluid [1,11,13]. Parathyroid tissue is found on histological examination forming islands surrounded by fibrous tissue, this confirms the parathyroid nature of the cyst [1,11,14,20,21].…”

Section: Discussionmentioning

confidence: 89%

“…On average the size of cysts varies between 3 and 5 cm [7] with a fluid content between 2 and 75 ml [10]. Mediastinal cysts have been described with a size of up to 12 cm [11]. Many hypotheses have been suggested to explain the development of parathyroid cyst: degeneration or bleeding of the parathyroid gland or an adenoma which forms active cysts in the parathyroid cell wall [7,8] development of embriological residuals [12,13] retention of the secretions of the colloid vesicles or enlargement of microcysts by retention [14] forming inactive cysts with a clear liquid.…”

Section: Discussionmentioning

confidence: 99%

“…Elsewhere examination will note a palpable anterior cervical mass [2,16] or laterocervical base masses [15,17] which is smooth, renitent and mobile presenting like a thyroid nodule. The cervico-mediastinal cysts can give the impression of a plunging goitre [11]. This mass can appear serious if associated with pain (raising suspicion of a haemorrhagic complication).…”

Section: Discussionmentioning

confidence: 99%

“…Its localisation has been widely reported in the literature where 94 of 250 cysts listed were parathyroid [11] meaning that the incidence of mediastinal glands is between 2.5% -22% [10,17,19,22]. The cysts (active in 42% of cases [2]) are most often situated anterior to the mediastinum (82%) where they occur as cysts on inferior ectopic glands.…”

Section: Discussionmentioning

confidence: 99%

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Diagnosis and Therapeutic Management of Parathyroid Cysts

Finel¹,

Mucci²,

Branger³

et al. 2012

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Objectives: The parathyroid cysts (PCs) are rare and their diagnosis and therapeutic management are not clearly established. The aim of the study was to evaluate the characteristics of parathyroid cysts. Methods and Materials: Twenty-five patients with PC were included in this retrospective study. The PCs were discovered as follows: cervical mass (n = 18), screening for other pathologies (n = 7). Intracystic parathyroid hormone determination was performed in 6 cases. Results: Eight patients presented a hyperparathyroidism. Mean cyst size was 21.1 mm (ext 4 -70 mm) by 19.8mm (5 -45 mm). Twenty four cysts were cervical (resection by cervicotomy), and one was mediastinal (resection by sternotomy). In addition to the resection of the PC, 3 adenomas, 1 hyperplasia of the parathyroid glands, 14 benign thyroid diseases and 4 papillary carcinomas were recognized and treated during the cervicotomies. Conclusion: The diagnosis of PC is uncommon and must be based primarily on the study of the cyst liquid obtained by percutaneous puncture (intracystic parathyroid hormone measurement). True PCs are non functional.

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Diagnosis and Therapeutic Management of Parathyroid Cysts

Finel¹,

Mucci²,

Branger³

et al. 2012

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Radiology Quiz Case 1: Diagnosis

2010

Arch Otolaryngol Head Neck Surg

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Intracystic hemorrhage in a mediastinal cystic adenoma causing parathyrotoxic crisis

et al. 2007

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Background. We report a case of intracystic hemorrhage in a mediastinal cystic parathyroid adenoma causing parathyrotoxic crisis.Methods and Results. A 30-year-old man presented with a large neck mass, dyspnea, and abdominal pain. The patient's serum calcium and parathormone levels were elevated. Radiography showed a right tracheal deviation, ultrasonography identified a thyroid nodular goiter extending to the mediastinum with a large (4.0 cm 3 5.6 cm) cystic mass adjacent to the lower left thyroid pole. After IV fluid, pamidronate, and furosemide were administered, the patient underwent total thyroidectomy, and excision of the cyst and a small mass (2 cm 3 2 cm) adjacent to the upper right thyroid lobe. Histopathologic examination revealed a double parathyroid adenoma and identified the mediastinal lesion as a cystic adenoma with intracystic hemorrhage.Conclusions. Intracystic hemorrhage in a functional mediastinal cystic parathyroid adenoma is an extremely rare cause of parathyrotoxic crisis. Aggressive medical treatment should be immediately instituted, and surgery should be performed as soon as hypercalcemia is controlled. V

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Mediastinal parathyroid cysts revisited

Cited by 73 publications

References 30 publications

Diagnosis and Therapeutic Management of Parathyroid Cysts

Diagnosis and Therapeutic Management of Parathyroid Cysts

Radiology Quiz Case 1: Diagnosis

Intracystic hemorrhage in a mediastinal cystic adenoma causing parathyrotoxic crisis

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